MDGs 4 & 5: six years to the Countdown 2015 - The ICM is committed to work with our global partners to achieve MDG 4 and 5 by 2015. The World Health Report 2005 Making Every Mother and Child Count identified midwives as the essential human resource to reach MDGs 4 and 5. In 2008 the W110 concluded that the world needs 700,000 more midwives to reach those goals. We are doing our part by developing the three pillars of a strong international profession: global midwifery standards in education, global standards of regulation and strong member associations. And we are updating our 2002 Essential Competencies to keep up with maternal and newborn health needs. Each of our member associations will have these standards and new competencies as benchmarks to strengthen midwifery in all our countries. These tools will also serve to ensure our profession is more unified at practice levels globally. However, it is one thing to strengthen midwifery at the global level; and another for all of us to be active in the global campaigns to achieve the targets of MDG 5: Reduce maternal mortality; Provide universal access to reproductive health care.
Safe Motherhood and Midwives - More women are dying in pregnancy and childbirth in Sub-Saharan Africa today than 21 years ago when the Safe Motherhood initiative began. As was stated in September at the annual UN Assembly, MDG 5 is the only one of the 8 MDGs with no significant gains in achieving its targets. Twenty years later more than 500,000 women a year are still dying because they are pregnant. A further 9 million suffer complications that can result in life long pain, disability and social exclusion. Three million newborns die during the first week of life and another 3 million are stillborn: 20,000 deaths a day related to pregnancy and childbirth. Lack of political will from all our governments was cited as the primary reason for this poor progress. Globally, in not just the poor, but also in rich nations, the vast majority of governments don't care that the poorest and most isolated women and their newborns continue to die or suffer unnecessary morbidity and neglect in childbirth. But it is not only governments that are to blame. The disappointing reality is, civil society in the vast majority of our countries has not made maternal, newborn and child health a priority either at the national level, let alone at the international level.
White Ribbon Alliance for Safe Motherhood (WRA) - the WRA is working hard to strategically address this issue and is advocating through their 'Promises to Mothers Lost' campaign to reduce maternal mortality. Sarah Brown, wife of British Prime Minister, Gordon Brown, is the Patron of the WRA, and she gave an inspiring keynote address at the ICM Congress in Glasgow where 2000 midwives signed a petition asking the G8 to put maternal mortality as a priority on their agenda. The ICM is a global partner with the WRA and supports this important advocacy campaign. We are forwarding information and updates to all of our Member Associations, so that the information is passed on to individual midwife members. In support of 'Promises to Mothers Lost' the ICM will be working with our Member Associations in the months ahead to encourage alliances with the WRA at country level. The ICM will be able to share strategies, stories and achievements of these efforts on our website.
Maternal Mortality Campaign - Sarah Brown has also convened an international alliance of celebrities, wives of heads of states and others to rally international support to encourage governments to make safe motherhood a healthcare priority. One of the goals of this campaign is to establish innovative financing strategies and for 20 countries to have sustainable financial healthcare plans in place by 2010 to meet WHO recommended levels of 2 to 3 healthcare workers per 1000 people by 2015.
Global Health Workforce Alliance - In too many countries of the world, the central issue preventing the improvement of maternal and newborn health is a chronic and debilitating shortage of healthcare workers. WHO says the world needs more than 4 million more healthcare workers (one third management and support workers) to adequately meet the healthcare needs of the global population. While 1.8 million of these are needed in Africa, the numbers reflect an acute shortage of workers globally, in both rich and poor nations. In addition to workforce shortages, the problems are exacerbated with increased mobility of the current global health workforce. This mobility includes both the national 'brain drain' of experts from the public to the private health sector within poor countries, as well as health workforce migration from poor to resource rich nations.
Responding to a call by African Heads of State, the G-8 and the World Health Assembly at WHO, a global partnership was launched in May 2006, to address the worldwide shortage of nurses, doctors, midwives and other health workers. The Global Health Workforce Alliance (GHWA) is administrated and hosted by the WHO and mobilizes key stakeholders engaged in global health to help countries improve how they plan for, educate and employ health workers. ICM is a member of the GHWA.
Innovative Financing for Health Taskforce - The Global Health Workforce Alliance has identified that increasing the health workforce to the levels required today will cost billions of dollars. This issue was addressed during the UN Assembly in September, when the WRA and the PMCNH organized a side meeting in support of the Kampala Declaration. During the meeting, ministers from various countries made significant financial commitments to develop the health workforce to achieve MDGs 4 and 5. Great Britain pledged £450 million over the next three years to support national health plans and train more nurses, midwives and doctors in eight of the poorest countries. Norwegian Prime Minister Jens Stoltenberg announced that the Global Campaign for Health will aim to mobilize an extra $30 billion by 2015 to ensure 4 million more children's lives are saved and 33 million more births are attended by skilled health workers. And finally, the new Innovative Financing for Heald) Taskforce, launched by the UK, Norway, the World Bank and others, will work to fund over 1 million health workers by 2015.
As we all know, in the weeks following the UN meeting, the global economy and individual countries suffered tremendous financial losses. The World Bank recently noted that in this economic downturn the first programmes to disappear in country are the mother and infant programmes.
MDG 5 — The Challenge for Midwives - In the years ahead we must keep up pressure to make sure governments do not reverse their commitments. As effective and confident midwifery associations, we must lobby our governments at both the G8 and 020 levels to let them know midwives globally want all our governments to identify MDG 5 as a priority.
Why should we be active in this cause? Because we should be the most outraged of all. We share this burden as women. In our own ranks are midwives who have suffered from poor access to reproductive health care and have died in pregnancy and childbirth. No woman should die because she is pregnant. No woman should die because she is giving birth. No one knows that better than we do. Let's all help bring this global and personal tragedy to an end and let's do it together.
My very best to each of you,
Bridget
